Objective To analyze the clinical characteristics, diagnosis and treatment of four case neurosyphilis with transient ischemic at ack onset.Methods Review the clinical characteristics,blood and CSF examination and neuroimaging results of four patients with neurosyphilis in our hospital from July 2006 to November 2013. Results The ages of patients were between 26 and 42 years ( average 33.75 years).TIA symptoms show limb weakness (3 cases),dysarthria (2 cases),facial paralysis (1 case) and numbness(1 case). Patients show mental decline(4 cases), ocular symptoms(2cases),and psychiatric symptoms(1 case) at the same time or later after TIA. Leukocyte counts and protein levels in CSF were increased.3cases in RPR and 4 cases in TPPA of blood and CSF were positive. MRI showed mild cerebral atrophy,which focus on temporal lobe,and may have abnormal signal. Intracranial vascular may be normal ,also may have focal or dif use stenosis. Conclusion The incidence of neurosyphilis showed an increasing trend.The clinical characteristics of neurosyphilis are complex, which easily lead to misdiagnosis and missed diagnosis.Neurosyphilis is another important factor in young stroke.%目的：分析4例以短暂性脑缺血发作起病的神经梅毒的临床特点及诊断、治疗方法。方法回顾我院2006年7月~2013年11月4例神经梅毒患者的临床特点、血清及脑脊液检查和神经影像学检查结果。结果患者年龄26~42岁,平均33.75岁。患者TIA症状中肢体无力3例,构音障碍2例,面瘫1例,肢体麻木1例。在TIA症状出现的同时或稍后4例出现智能减退,2例出现眼部症状,1例出现精神症状。CSF白细胞数轻度增加、蛋白水平高于正常。血及脑脊液RPR3例阳性,TPPA4例阳性。头MRI示轻度的脑萎缩,以颞叶为主,可有异常信号。颅内外血管可正常,可有局灶性或弥漫性狭窄。结论神经梅毒的发病率呈逐年上升趋势,但其临床表现复杂多变,易误诊和漏诊,是青年卒中的又一重要因素。
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